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Management Impact of 68Ga-DOTATATE PET/CT in Neuroendocrine Tumors

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Abstract

Purpose

The goal of our retrospective single tertiary academic medical center investigation was to examine the added diagnostic value and clinical impact of 68Ga-DOTATATE PET/CT in the therapeutic management of patients with neuroendocrine tumors (NETs).

Methods

Imaging database was queried for all “PET-DOTATATE” examinations performed at our tertiary care academic institution using MONTAGE™. The patient’s clinical history and recent prior imaging were reviewed. The additional diagnostic value and clinical management impact of 68Ga-DOTATATE were assessed through retrospective chart review.

Results

A total of 81 68Ga-DOTATATE PET/CT scans in 74 patients were found, and 11 patients were excluded from analysis as they had no prior imaging available for comparison, with resultant analysis cohort of 63 patients. Six patients had 2 or more 68Ga-DOTATATE PET/CT examinations. The most common primary diagnosis was undifferentiated NET (63.5%), followed by carcinoid (27.0%), paraganglioma (4.8%), insulinoma (3.2%), and pheochromocytoma (1.6%). The primary sites of disease from the most to the least common were the pancreas (36.5%), small bowel (22.2%), unknown primary (15.9%), lung (6.3%), large bowel (6.3%), and mesentery (4.8%), and other locations accounted for 7.9%. In patients who had prior imaging available for comparison, there were new lesions identified on 68Ga-DOTATATE PET/CT in 21 patients (33.3%) that were not identified on other prior imaging modalities. Of these patients, 5 underwent subsequent MRI and 1 had a repeat 68Ga-DOTATATE PET/CT to further characterize new lesions seen. Moreover, 15 patients (23.8%) had a change in treatment plan, including altering medical therapy in 9 patients, change in planned extent of surgical management in 5 patients, and cancelation of a planned primary tumor resection in 1 patient with metastatic disease.

Conclusion

Our retrospective cohort demonstrated that 68Ga-DOTATATE PET/CT improves lesion detection over conventional imaging in 33.3% and impacts the therapeutic management in 23.8% of patients with NET.

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Funding

The study was supported in part by a grant from the US National Cancer Institute, National Institutes of Health, P30-CA014089 (USC Norris Comprehensive Cancer Center).

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, 2250 Alcazar St., CSC 102, Los Angeles, CA, 90033, USA

    Redmond-Craig Anderson, Erik M. Velez, Bhushan Desai & Hossein Jadvar

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  1. Redmond-Craig Anderson
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  2. Erik M. Velez
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  4. Hossein Jadvar
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Correspondence to Hossein Jadvar.

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Conflict of Interest

Redmond-Craig Anderson, Erik M. Velez, Bhushan Desai, and Hossein Jadvar declare no conflict of interest.

Informed Consent

The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived.

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Anderson, RC., Velez, E.M., Desai, B. et al. Management Impact of 68Ga-DOTATATE PET/CT in Neuroendocrine Tumors. Nucl Med Mol Imaging 55, 31–37 (2021). https://doi.org/10.1007/s13139-020-00677-0

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  • DOI: https://doi.org/10.1007/s13139-020-00677-0

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